Abstract:

Iron deficiency (ID) and anemia of chronic diseases (ACD) are the most common causes of anemia in inflammatory
bowel disease (IBD), and frequently coexist. In these circumstances, detection of ID may be difficult as inflammation
influences the parameters of iron metabolism. The prevalence of iron deficiency anemia (IDA) ranges between
36% and 76% in this population of patients. Anemia may impair physical condition, quality of life (QOL), and
cognitive function, negatively affecting almost every aspect of daily life. Furthermore, it may be one of the causes of
death in IBD. Consequently, iron replacement therapy should be initiated as soon as ID or IDA is detected, together
with the treatment of underlying inflammation. Oral iron therapy is a simple and cheap treatment, but often is poorly
tolerated and may worsen the intestinal damage. Moreover, in inflammatory states, duodenal iron absorption is blocked
by a cytokine-mediated mechanism. Consequently, intravenous iron therapy is preferred in the presence of severe
anemia, intolerance or lack of response to oral iron, and moderately to severely active disease. Recently, new intravenous
iron compounds (iron carboxymaltose, iron isomaltoside 1000, ferumoxytol) have become available. Iron carboxymaltose
has been shown to be safe and effective in IBD patients with IDA. Furthermore, it allows for rapid administration
of high single doses, saving time and costs. If proven to be efficacious and well tolerated, it may become
the standard therapy in the near future.

Abstract:Iron deficiency (ID) and anemia of chronic diseases (ACD) are the most common causes of anemia in inflammatory
bowel disease (IBD), and frequently coexist. In these circumstances, detection of ID may be difficult as inflammation
influences the parameters of iron metabolism. The prevalence of iron deficiency anemia (IDA) ranges between
36% and 76% in this population of patients. Anemia may impair physical condition, quality of life (QOL), and
cognitive function, negatively affecting almost every aspect of daily life. Furthermore, it may be one of the causes of
death in IBD. Consequently, iron replacement therapy should be initiated as soon as ID or IDA is detected, together
with the treatment of underlying inflammation. Oral iron therapy is a simple and cheap treatment, but often is poorly
tolerated and may worsen the intestinal damage. Moreover, in inflammatory states, duodenal iron absorption is blocked
by a cytokine-mediated mechanism. Consequently, intravenous iron therapy is preferred in the presence of severe
anemia, intolerance or lack of response to oral iron, and moderately to severely active disease. Recently, new intravenous
iron compounds (iron carboxymaltose, iron isomaltoside 1000, ferumoxytol) have become available. Iron carboxymaltose
has been shown to be safe and effective in IBD patients with IDA. Furthermore, it allows for rapid administration
of high single doses, saving time and costs. If proven to be efficacious and well tolerated, it may become
the standard therapy in the near future.